Please complete as fully as possible, e.g. working hours, flexibility, etc.
Legally aided YesNoNot sure
Liable to pay fees YesNoNot sure
Please give details, including court and hearing date.
Is there a history of domestic violence? YesNo
Is there a history of child protection issues? YesNo
Please tick main issues.
Pre-separation issuesChild arrangementsPost-divorce problemsReaction to divorce/separationFinance and propertyOther
Is other party aware of referral? YesNo